Call on everyone in the physician's office

November 1, 2000
Gwen McLean
Gwen McLean

Gwen McLean is a managing editor at Walpole, MA-based Informa Training Partners. For more information on training materials that prepare pharmaceutical sales professionals to succeed in today's marketplace, contact Informa Training Partners at (508) 668-0288 or visit Informa online at www.informatp.com.

Pharmaceutical Representative

Become a resource to the doctor's staff.

As a pharmaceutical sales representative, your job requires you to call on physicians, explain the features and benefits of your products, address managed care challenges, and increase your products' market share. However, as you know, gaining access to physicians can be extremely difficult, which makes discussing your products with them seem next to impossible. If you can't get in to see the physician, how do you let him or her know how great your product is?

As the saying goes, sometimes the fastest way to get from A to B is not a straight line. Calling on a physician who repeatedly refuses to see you wastes your time and gets you nowhere. Instead, try calling on the whole office. You may be amazed at what you can learn by talking with the office manager or a member of the medical support staff. Even the receptionist can provide you with information that could help you understand the needs of the practice and the physicians within it, and if you play your cards right, get you an appointment with that elusive physician!

Befriend the receptionist

It's impossible to see the doctor if you cannot get past the receptionist, so it is in your best interest to develop amicable relationships with these gatekeepers. Demonstrate professional courtesy and realize that their time is precious. In a typical day, a receptionist appeases patients tired of sitting in the waiting room, relays phone calls from pharmacies requesting refills and substitutions, tries to keep the physicians on schedule, fills out insurance forms and completes hundreds of administrative tasks.

When you walk into the office, you do not want the receptionist to think, "Oh, no. Here comes another drain on my time." You would like the receptionist to say, "Hi. Glad to see you. Have a seat and the doctor will see you as soon as she's finished with her patient."

How do you ensure that receptionists are happy to see you? Find out what they need to make their jobs easier. Does he like a certain kind of pen that your company provides? Could she use a laminated list of local pharmacies, their phone numbers and contact names? Could you save him the time it would take to go out and get lunch by bringing him a sandwich? Small favors can make a big difference.

Support the office manager

The office manager can provide you with valuable information, including the office's payer mix. In other words, he or she can tell you how many patients are covered by Medicare, Medicaid or a particular third-party plan, and how many pay for their care out of pocket. The office manager can also tell you about the pharmacy benefits provided by the different payers and let you know about the administrative and financial challenges facing doctors in the office.

Knowing your customer's payer mix and the benefit designs of those payers can help you determine which plans and designs most strongly impact your customers. This information can be helpful in positioning your products to meet your customers' needs.

For example, you may find out from the office manager that Plan A covers 40% of Dr. Z's patients and that, because your product is on the third tier of Plan A's formulary, Dr. Z tends not to prescribe it for those patients. Apparently, the doctor is not convinced that your product offers any clinical advantages to those patients. You now know that you need to educate Dr. Z on your product's clinical benefits. Had you not learned this from the office manager, you might not have known how to approach Dr. Z.

The moral of this story is that you do not necessarily have to speak directly to doctors to learn about their challenges. By speaking to another member of the office staff – one who is easier to access – you may learn the same thing.

How do you turn the office manager into an ally? As with the receptionist, find out his or her needs and provide solutions. For example, an office manager might learn that your product has been bumped from a formulary by receiving a letter of reprimand after a script for your product has been written. One action you can take to help the office manager and the rest of the office avoid these reprimands is to provide updates on formulary issues affecting your products.

Respect nurses and PAs

In the physician's offices you call on, you will likely encounter a variety of allied healthcare professionals, including physician assistants, nurse practitioners, registered nurses, licensed practical nurses and nurse educators.

Physician assistants and nurse practitioners may have prescribing privileges with varying levels of physician oversight. Whether or not they can write scripts depends on the laws of the state in which they practice. If you cover a territory in which physician assistants and nurse practitioners have prescribing privileges, it is essential that you add them to your regular call list. They, just like doctors, can help you build market share for your products.

Registered nurses and licensed practical nurses often call in refills and field calls from pharmacists asking to switch a patient's medication to a product on the formulary. Although registered nurses and licensed practical nurses do not have prescribing privileges, some do recommend medications, so it is crucial to keep them informed just as you do the doctors.

Nurse educators are generally found in large offices. They tend to specialize in particular disease areas like diabetes or asthma and appreciate patient education materials and up-to-date product information.

Regardless of which types of allied healthcare professionals work in the offices you call on, it is important that you build relationships with them. Not only are they good sources of information, but in many offices they can influence prescribing behavior.

How can you develop productive relationships with allied healthcare professionals? Treat them like you treat your physician customers. In fact, nurses can sometimes tell you more about the impact of your products on patients than doctors, because they typically respond to patient phone calls. Thus, they hear straight from the patients about unpleasant side effects as well as efficacy and reimbursement issues. So give allied healthcare professionals the same studies and educational information that you give doctors, ask them about what aspects of managed care are making their jobs difficult and provide assistance when possible.

Make a difference

As a sales professional, you know that two fundamental steps of selling are (1) determining the needs of your customers and (2) fulfilling them. Managed care has not changed this. What managed care has done is increase the needs of your customers, and consequently, increase the number of ways you can meet those needs. This, in essence, provides you with more opportunities to help your customers.

By building strong working relationships with the administrative and medical support staffs, along with the physicians, you can learn about the challenges managed care has placed on all those who work in a physician office. Armed with this information, you will be able to design solutions to meet these challenges, set yourself apart from your competitors, and ensure continued access that will lead to market share growth in the future. PR

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